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PEDIATRIC AND MENTALLY RETARDED POPULATIONS

PEDIATRIC AND MENTALLY RETARDED POPULATIONS. Minimum Response Levels (MRL’s). No response at threshold Respond at supra-threshold levels Response = hearing No response = hearing still possible . Hearing and Language Development. Babbling (6 months) still present in hearing impaired

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PEDIATRIC AND MENTALLY RETARDED POPULATIONS

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  1. PEDIATRIC AND MENTALLY RETARDED POPULATIONS

  2. Minimum Response Levels (MRL’s) • No response at threshold • Respond at supra-threshold levels • Response = hearing • No response = hearing still possible

  3. Hearing and Language Development • Babbling (6 months) still present in hearing impaired • Lalling (6mos - 9mos.) • Echolalia (9 - 12 mos.) is NOT present with hearing impaired child • True Speech (12 - 18 mos.) - delayed in many hearing impaired • 2 ½ years is normal Dx of hearing impairment in US

  4. We must answer these questions……. • Can we detect hearing loss in the infant • Can we diagnose the loss • Can we do any treatment about it

  5. Apgar Test • Respiratory • Muscle tone • Heart rate • Color • Reflex irritability • Values 0 - 10 at 1, 5, & 10 minutes after birth

  6. Warble tone A pure tone that is frequency modulated (modulation is expressed as a percentage, i.e. 5%) • Downs (1967) • Startle response (3KHz at 90 dBSPL- Moro reflex 1-3 mos) • Risk factors (high risk registry for inclusion in testing) • Combine ABR’s with acoustic reflex and OAE’s

  7. Neonates (0 - 28 days) • Infants (29 days - 3 years) • Pre-school (3 - 5 yrs.)

  8. Screening • ABR • OAE’s • Acoustic reflex

  9. Infant testing • Noise makers • Behaviorial Observation Audiometry (BOA) keys, cellophane etc.) • Sound field/free field • Conditioned Orientation Reflex (COR) • Visual Response Audiometry (VRA)

  10. Ewing & Ewing 1944 • rattles • paper • noise makers • cup and spoon

  11. Auditory localization - 8 months or later • they search for sound source • cease activity • awaken from a light sleep • facial expression changes • vocalize

  12. 1 - 5 years • Speech Audiometry • Pure tone Audiometry • Operant Conditioning Audiometry • Tangible Reinforcement Operant Conditioning Audiometry (TROCA) • Electrophysiological hearing tests • Electro-dermal audiometry (EDA) • cardiotachometry

  13. 1- 5 Yrs ( continued) • Play Audiometry (peg board) • Child must be motivated • Must have his attention • Reinforcement must be strong • Central Auditory Processing Disorder (CAPD or L.D.) • May have normal hearing but processing poor • poor listening skills • Short attention span • Poor memory • Reading comprehension deficient • Hyperactive + trouble discriminating in presence of noise

  14. School Age • Group ScreeningTests • Sweep Check Tests • Individual pure tone thresholds • Tympanometry

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